First blood test after starting Peg 17/12/2023

[Carol0925]

Hi, Blood test from 28/12/2023

Platelets down to 427 (previous 580, 560, 504).

Elevated Potassium 5.4 and ALT 96.

I guess Peg has elevated ALT??

My next FU is March 14th. I’m really hoping I don’t have to increase Peg which is currently 45 weekly.

[hunter5582]

The elevated ALT is likely due to the PEG as this is a known side effect. Mild elevations in ALT are not usually a concern when taking an IFN. Mine have been as high as 3x/Upper Limit of Normal on Besremi. I was able to return my LFTs to normal using a milk thistle extract prescribed by my Integrative Medicine doctor.

Suggest you touch base with your MPN care team for guidance prior to your next visit.

[Carol0925 in reply to hunter5582]

Thank you Hunter.

[Mishie14]

I also had elevated liver enzymes and thanks to this site started milk thistle extract and the values came down. ALT got stubborn and stopped at 75 but neither is it going up. Keeping the milk thistle in my treatment. Also had high potassium results. The first two times above 5.2 (5.4 and 5.7) I was sent to ER. ER doctor said he’s seen this before and did serum test that was fine. Again from this site brought up the topic and shared with my hematology which proved it was the blood draw method and my circumstance of 900k platelets at the time. Ever since my lab blood tests include a special potassium serum check. Blood for that test is put in a green covered tube which here means it is coated with heparin to prevent coagulation. Potassium serum has consistently been fine at 4.1 to 4.5. However, high potassium serum can lead to serious cardiac event so do get it checked out. Peginterferon has been very good for me. A few surprises but easily addressed. Good luck to you and stay safe.

[Carol0925 in reply to Mishie14]

Thank you. I’m going to telephone my Team as an Admin Coordinator kindly emailed my results yesterday. Best to be safe .

[Mishie14]

I should have included the potassium reference: Pseudo-hyperkalemia is the name of falsely elevated potassium level due to disruption of platelets during the collection or processing of the blood sample. Use of tourniquet, closed fist, size of needle, sample storage, length of vial travel and type of travel from collection point to analysis point are examples of possible types of disruption. When red cells are mashed or otherwise damaged, potassium among other things they carry is released which causes high potassium in test blood.